Exploring hysterosalpingography findings and pregnancy results among women applying to a tertiary referral hospital

Abstract

Aims: To find out the correlation between hysterosalpingography (HSG) pathologies and pregnancy results of infertility patients. Infertility is a complicated complaint prevalent among women of reproductive age with severe financial and social consequences. HSG, adopted for evaluating infertility, can be considered a secondary imaging technique in practice following ultrasound examination. The present study attempted to explore the HSG results of patients applying to our hospital with the complaint of infertility in the last two years and to compare these results with their pregnancy. Methods: We retrospectively evaluated the HSG results of the patients applying to or referred to our hospital from an external center between 10.01.2018 and 30.08.2020 with the complaint of infertility.260 patients were included in the study. The patients were grouped by their primary and secondary infertility. We analyzed anomalies detected by HSG in two groups: uterine and tubal anomalies. Moreover, those becoming pregnant following HSG until June 2022 were grouped by reproductive techniques (spontaneous or assisted). Patients not having optimal imaging, with HSG reports obtained at an external center, and with insignificant results were excluded from the study. Results: The patients’ mean age was calculated to be 36 years (21-52 years). While 144 patients (55%) were diagnosed with primary infertility, 116 (45%) had a diagnosis with secondary infertility. There was no uterine or tubal anomaly in 157 patients undergoing HSG, but we discovered only a uterine defect in 28 of 103 patients and a tubal defect including at least one uterine and comorbid tuba in 44 patients. In 45 patients with a uterine anomaly, the most prevalent HSG findings were uterine filling defect (28 patients, 62.2%) and arcuate uterus (10 patients, 22.2%). We also discovered that 81 patients became pregnant at least once after HSG. While 50 of them got pregnant spontaneously, the remaining benefitted from assisted reproductive techniques. Our findings showed spontaneous pregnancy not to be associated with primary or secondary infertility (p=0.394; OR=0.765; 95% CI: 0.412-1.42). There was also no relationship between primary and secondary infertility and abnormal HSG findings (p=0.437; OR=0.820; 95% CI: 0.498-1.35). Finally, we concluded that abnormal HSG findings did not significantly contribute to the rate of spontaneous pregnancy (p=0.701; OR=1.13; 95% CI: 0.604-2.11). Conclusion: We concluded that abnormal HSG findings did not contribute to the rates of spontaneous pregnancy.